Medical Examiner Report & Wallet Card

The current expiration date of these MCSA forms is 3/31/2025.

The Medical Examination Report Form for commercial driver fitness determination contains all the information required by 49 CFR 391.41. This form measures 8 1/2" x 11". These form are custom bonded into padded form per 50. Orders for less than 50 are not padded.

The Medical Examiner's Certificate Wallet Card is required to be carried by every driver of a commercial motor vehicle as a proof of medical qualification in 49 CFR 391.41. This driver card fits any standard size wallet.

The Medical Examiners Certificate Report and Wallet Card is an integral part of the driver qualification file.

This Medical Examiner's Certificate is printed on tri-fold business cardstock. It features a write-able matte finish. This certificate measures 6"W x 3.5"H unfolded. Once completed it folds down to 3.5" x 2" (business card size) to fit any standard size wallet. This unique MCSA-5876 Medical Examiner's Certificate is 100% driver preferred!

Includes:

(1) Medical Examiners Report - MCSA-5875

(1) Medical Examiners Certificate Wallet Card - MCSA-5876

This is the official MCSA-5876 Medical Examiner's Certificate and MCSA-5875 Medical Examination Report for all 50 states:

Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin and Wyoming.

Quantity pricing applied in cart.